Flight : An Aeriel View of Addiction

11/28/2012 12:40 pm ET Updated Jan 26, 2013

I've seen her so many times, the obese woman with an aura of nicotine who staggers into my allergist's office, gasping, her pudgy hand at her throat. "I have to see the doctor right away," she rasps. "I can't breathe."

You can tell that she wants to breathe, wants to live, but she won't or can't stop smoking and overeating. I always feel magnanimous toward her until the receptionist lets her see the doctor before me, even though I've been waiting a half-hour.

I thought about her today when I left Flight, the movie where Denzel Washington plays a gifted pilot who miraculously brings a rattletrap plane through vicious weather conditions and lands it safely in a field even as the plane is falling apart. But he is enraged when it comes out that he was drunk on vodka and high on cocaine when he managed to pull this off. He thinks it's his choice to drink, no matter that it's ruined his marriage, his relationship with his son, and leaves its grime on everyone he gets close to, such as the lyrically melancholic Kelly Reilly who wants him to sober up, think about his future, their future.

Abraham Twersky, M.D. in his book, Addictive Thinking: Understanding Self-Deception (a Hazeldon Book from Harper Colins, 1990), says (p. 21) that addicts do think of the future, but in moments, not years. The addict "thinks the consequences of his addiction is a glow, a detachment from the world, and perhaps sleep. This will happen within a few minutes of the addicts using, and these few minutes make up the addict's future. Cirrhosis of the liver, brain damage, loss of family and job do not happen within minutes, so they do not exist in the addict's thoughts."

You don't have to be psychic to know the future of the obese woman marinated in cigarette smoke: emphysema, heart attack, maybe stroke. And she complains that her knee and feet are killing her, but is in denial about the cause.

"My orthopedist said that if I lost 50 pounds my knee would improve dramatically," she told the receptionist once. "And I told him, 'Hah, if it was my weight causing the problem, then both my knees would hurt.'"

You can just imagine this woman at some point using a walker fitted out with an oxygen tank. It's so sad and such a cost in human potential and to our health-care system. But she can't think beyond her next Marlboro, past the sprinkles and chocolate glaze of her next donut.

The next time she usurps my allergist appointment, I have to remember how ill this woman truly is beyond the physical symptoms she's causing herself. I must have patience, something that the addict himself lacks.